How do I know what is AF and what is ectopic beats?

[Walison]

I have paroxysmal AF and had an ablation last Nov after a few nasty episodes of fastAF and  cardioversions. I am taking bisoprolol and warfarin. From time to time I have episodes of what I call palpitations.They come and go. I don't know whether this is AF showing itself differently or whether they are ectopic beats. Is there a good way to tell? I've has ECG's but unless the palpitations are happening at the moment of the ECG nothing shows .Any pearls of wisdom on this? I'm a worrier !

[CDreamer]

It is obvious on an ECG trace as ectopics show as a V going the opposite direction whereas you will see an absence of the P wave just prior to the QR wave which will show the normal way.  

Without taking an ECG the only way to describe the difference as I experience it (we are all different) is that ectopics feel like a missed beat followed by a run of palpitation in rapid succession whereas AF felt like a constant but irregular pounding in my chest - as if my heart was dancing to an irregular beat at a disco, which was sustained for hours if not days.  Ectopics rarely lasted more than a few seconds at a time, but can make you feel just as crap.

Some people have AF for just a few seconds so in that instance it will be difficult to distinguish but remember that worry and anxiety is going to make both worse so think about what you can do to help yourself to ease your anxiety.  

CBT is very good for worry thoughts - see if you can capture your thoughts on paper and then focus on the anxiety that provokes and challenge the thought eg:-  

Thought-  if these palpitations ARE AF that means .........................

Challenge to thought - Even if these palpitation are AF and they make me feel ill they are not going to kill me, even if it may feel as though it will.

Which would be worse for you - ectopics or AF?

[Bob56]

Hi For me an easy  of telling the difference between AF and ectopics is to feel my pulse and simply count the beats. In non medical terms if the beat is irregular and random ( doesn't have to be fast necessarily) or no discernible pattern then it is AF. If the heart beats regularly but every certain number of beats it appears to skip one, then that's ectopics. If I'm having a "mild" ectopic session then I might have 10 normal beats for every skipped one. If it's severe, then every other beat is a missed one ( although we know this isn't actually what's happening). If you are unsure then a 24 or 48 hour holter test should confirm it. You will be asked to press the button on the kit every time you feel any sort of palpitation, and it can then be confirmed one way or another. I suspect it is ectopics from the way you describe them, and as you know doctors are much less worried about them than AF. I still hate them as you tend to feel anxious and out of sorts, but unlike AF they don't generally  affect things like exercise or your stamina. Oh , and worrying can make ectopics worse..its perverse and a bit of a Catch 22,  but deep breathing, relaxation, and meditation  exercises have been known to help.

 

[Walison in reply to Bob56]

Thanks Bob. I'll monitor my pulse as and when. Things are calm at the mo!

[Bob56]

I'm glad things are calm at present. I should have added, that it is quite possible that your heart is still settling after your ablation. It can take up to a year for the heart to properly recover and until then you can get all sorts of strange sensations and feelings, as I know only too well!